Culturally Competent Play Therapy with the Mexican Child and Family

Roberto Robles, LCSW

Learning Objectives

• How to engage the Spanish speaking Mexican child and the family

• Identify ways to treat the Mexican child and family by using culturally appropriate games

• Understand the different ways to use the traditional games and Historia de la Loteria/Lotto Story in a therapeutic manner

Cultural Inventory

• What messages are you conveying when the family enters your Waiting room?Office?Fills out your forms?Return a phone call?

Common Practice

• Usually there is sensitivity to the Language needs Leaflets Brochures Videos Forms in Spanish

• What about once they enter the office?

Assessment Issues

• What kinds of questions do you ask? ImmigrationReligionTreatment approachesDiscipline

Some Games Used in therapy• Candyland

• Therapeutic games• The Talking, Feeling and Doing Game

Available in Spanish Doesn’t take into account culture

• Only two bilingual therapeutic games that can be used by Spanish-speaking or bilingual children and their parents.

Games to Use with Mexican Children

• La Loteria

• Juego de la Oca (Game of the Goose)

• Sierpientes y Escaleras (Snakes and Ladders)

• Historia de la Loteria/Lotto Story

Narrative Therapy developed by Michael

White and David Epston• Implies listening to the child and

family’s story about their problems

• Told once or more than once

• Language can shape events into narratives of hope

Narrative Therapy

• Problems arise when a person is stuck in a story that makes him or her unhappy• Narrative therapy is a search for

events which disprove some erroneous beliefs• A new story can liberate the

person from the shackles of the problem

Narrative Ideas

• People are the experts

• Views problems as separate from people

• Emphasis on the story

• Allows for the telling and retelling of stories

Narrative Therapy

• Children and some adults naturally externalize problems

• Doing this separates the child from their problems

• It directs the focus away from the child as a problem and onto the child-problem relationship

Narrative Therapy

• “The problem in the problem, the person is not the problem”

La Loteria in Mexico

• Colonial Spanish card game

• Arrived in Mexico during the last half of 18th century

• First played in a parlor by social elite

• Still widely played

How it can be played

• Up to six people and one caller

• Caller pulls individual cards from a bag or hand

• Each player selects at least one game card

• Three or four in a row wins

Another traditional way to play

• Players place bets on the picture on their game card which they feel the caller will next pull from the bag• This version is played at carnivals

in Mexico• Caller has a bowl of oversized dice

that have the pictures on each side instead of dots or numbers

In Oaxaca

• Poetic verses are shouted out• I’m the ___and

I’ve arrived although you can’t see me; I haven’t come to borrow, not even to eat.

Riddles and Rhymes Acertos y Rimas

• El sombrero de los reyes

• The hat of kings

• Para el sol y para el agua

• For the sun and water

Riddles and Rhymes Acertos y Rimas

• El que por la boca muere

• One that dies by the mouth

• El que con la cola pica

• The one that picks with its behind

Riddles and Rhymes Acertos y Rimas

• La guía de los marineros

• The sailors guide

• El farol de enamorados

• The lantern of lovers

Riddles and Rhymes Acertos y Rimas

• Al que todos van a ver cuando tienen que comer

• Where all go when they have hunger

• El que le cantó a San Pedro no le volverá a cantar

• He that sang to St. Peter will not return to sing again

Riddles and Rhymes Acertos y Rimas

• Pórtate bien cuatito si no te lleva el coloradito

• Behave yourself so that the little red one doesn’t carry you off

• Al pasar por el panteón, me encontré

• While passing the graveyard, I found

Riddles and Rhymes Acertos y Rimas

• La herramienta del borracho.

• The tool of the drunk.

• ¿Por qué le corres cobarde trayendo tan buen puñal?

• Why are you running like a coward when you are carrying such a good dagger?

Riddles and Rhymes Arcetos y Rimas

• La cobija de los pobres

• The blanket of the poor

• Tanto va al agua

• Where the water goes

La Loteria--in clinical setting

• Winner tells a story about himself/herself or a family member or just a story using each of the cards--four in a row

• Winner identifies the feelings that they have when they see or think about the image

• Excellent alternative to the Thematic Apperception Test (TAT)

La Loteria--in clinical setting1 on 1

• Display all cards on floor or table• Have child select five cards--develop a story• Turn them upside down and have them

select five--have them do the same--develop a story• Place all face up--have child place emotion

peg on top• Go fish game with two decks--if there is a

match tell the story

Let’s play--hay que jugar

Tell a Story

Historia de la Lotería/Lotto Story

• Bilingual bicultural game

• Came about after a search was made for culturally appropriate therapy games

• Influenced by La Lotería, the Mexico City Metro

Emotional Pegs/Fichas Emocionales

• Four years of treatment• Card numbers 14, 11, 40, 19, 1, 10, 44• A little girl it was her birthday and she was sick and her parents

brought her candy and ice cream. They went to the store only to find out they were out of money. She could not pay for the little girl’s party and the little girl thought every one in the world hated her so she did not get anything [for her party]

Juego de la Oca (game of the Goose)

• Some say it dates back to 1471 in Germany, others say in 1587 in Italy, a copy was sent to King Philip II of Spain, very popular in 1700’s in France• When it arrived in Mexico some of the

images were changed to reflect the culture El Charro La China poblana La Pirámide

Sierpientes y Escaleras

• Originated in India, game is Hindu• It was used to teach children about the

religion where good squares allow a player to ascend higher in the league of life whereas, evil will reduce a player back through reincarnation to the lower tiers of life• Rewards good deeds-up ladder• Consequences for misdeeds-down the

snake

Individual images

Why is this important?

State’s Latino Births

• Beginning in July of 2001, more than half of all California babies were Latino• According to a UCLA study of birth

records• www.sfgate.com• Tyche Hendricks, Chronicle Thursday,

February 6, 2003

Cultural Competence

• It is a life long process• Refers to the process by which individuals and

systems respond respectfully and effectively to people of all cultures, languages, classes, races, ethnic backgrounds, religions, and other diversity factors in a manner that recognizes, affirms, and values the worth of individuals, families, and communities and protects and preserves the dignity of each

• NASW Standards for Cultural Competence in Social Work Practice 2001

More on cultural competence

• Is the integration and transformation of knowledge about individuals and groups of people into specific standards, policies, practices, and attitudes used in appropriate cultural settings to increase the quality of services, thereby producing better outcomes (Davis & Donald, 1997)• NASW Standards for Cultural Competence

in Social Work Practice 2001

It conveys the Attitude • That one is respecting a person’s

Immigration status migration status colonization acculturation experiences diverse heritages

• U.S. Department of Health and Human Services, SAMHSA, CMHS

La cultura cura no locura

Thanks-Gracias

• Howard (91) in Culture tales… (American Psychologist 46(3)

• Life-- Stories we live by

• Psychopathology-- stories gone mad

• Psychotherapy-- Exercises in story repair